More can be done to ease the burden of disease

Cigarettes via prescription only?

Although the overall health of Australians continues to improve, a new report shows that further gains could be achieved by reducing leading risk factors such as tobacco use, overweight [including obesity] and high blood pressure.

The `Australian Burden of Disease Study 2018: key findings’ report by the Australian Institute of Health and Welfare (AIHW), measures the number of years living with an illness or injury [the non-fatal burden] or lost through dying prematurely [the fatal burden].

“In 2018, Australians lost five million years of healthy life due to living with or dying prematurely from disease and injury. Non-fatal burden accounted for 52% of total burden, and fatal burden accounted for 48%,” says AIHW spokesperson Richard Juckes.

The five disease groups that caused the most burden were cancer (18%), musculoskeletal conditions (13%), cardiovascular diseases (13%), mental & substance use disorders (13%), and injuries (8.4%).

“After accounting for the increase in size and ageing of the population, over the 15 years to 2018, the total burden of disease decreased by 13%. The majority of these gains are attributed to a 24% decline in fatal burden, with rates of non-fatal burden remaining stable,’ says Mr Juckes.

“Of the five million years of healthy life lost, 1.9 million (38%) of these were potentially preventable by reducing exposure to the risk factors included in the study.”

Overall, tobacco use contributed the most burden of all risk factors at 8.6%, followed by overweight [including obesity] (8.4%), dietary risks (5.4%), high blood pressure (5.1%), and alcohol use (4.5%).

Tobacco use was the leading risk factor for both males and females and contributed the most to fatal burden, with almost 20,500 deaths (13% of all deaths) in 2018. Overweight [including obesity] was the highest contributor to non-fatal burden.

However, due to declines in smoking prevalence and associated diseases, the gap in total disease burden due to tobacco use and overweight [including obesity] has been narrowing over time.

The report shows that there are variations in burden of disease depending on where Australians live.

“People living in the highest socioeconomic areas lived more years in full health, without disease or injury, compared to those in the lowest socioeconomic areas,” says Mr Juckes.

“Additionally, those living in remote and very remote areas experience 40% higher burden compared to those in major cities.”

While data in this report predates the Covid-19 pandemic, a forthcoming report from the AIHW, `The first year of Covid-19 in Australia: direct and indirect health effects’, contains information on the burden of disease from Covid-19 in 2020 [data is not available for 2021]. Due to Australia’s success in containing the virus during the first year, the burden due to Covid-19 was very low, ranking around 135th out of 219 diseases based on 2018 numbers.

In comparison, the burden from Covid-19 in Scotland, the only other country to have published comprehensive analysis, would have likely made it the second leading cause of burden behind coronary heart disease.

Detailed findings from the Australian Burden of Disease Study 2018, and a report detailing the burden of disease experienced by Aboriginal and Torres Strait Islander people are planned for release in late 2021